A case report of post-acute COVID-19 encephalopathy

Introduction Following the protracted duration of the coronavirus pandemic, the Serbian health system now faces a period of mid- and long-term health consequences in patients that have recovered from the acute phases of infection. Objectives A 57-year-old woman presented at a psychiatric examination complaining of forgetfulness, listlessness, fatigue, insomnia, low mood, and decreased efficacy in daily activities, two months after infection with the SARS-CoV-2 virus. The clinical picture of acute COVID-19 infection was accompanied by an elevated body temperature, a cough, an increases of CRP, and X-ray verified bilateral pneumonia with band-like speckled shadows of milk glass density. Before infection, she was vaccinated with 3 doses of the Sinopharm Covid-19 vaccine. Methods The following examinations were made: MRI of endocranium, HDRS, laboratory examination, and neuropsychological testing. Results MRI of endocranium (figure 1): extensively cortico-subcortical lesions extensively within both cerebral hemispheres, dominantly in the temporo-insular regions, in association with partial parenchymal defects and a high degree of atrophy - the overall morphology corresponds to chronic encephalopathy, which is of non-specific morphology; HDRS score of 24; elevated serum levels of IgM, IgG, albumin in serum 7.05 (35-55), albumin in cerebrospinal fluid 812.0 (0-35), albumin index 115.8 (<9.0); IEF: oligoclonal bands in CSF and serum; neuropsychological testing: decrease in general mental activity and visuoperceptive and visuospatial ability. Due to the temporal connection between infection with the SARS-CoV-2 virus and presented symptoms, the patient was diagnosed with post-acute COVID-19 encephalopathy. Image: Conclusions A meticulous follow-up post-acute SARS-CoV-2 infection monitoring and care could decrease mortality and prevent debilitating neurological and other burdens, especially in risk groups. Disclosure of Interest None Declared

Introduction: Long COVID patients have experienced a decline in their quality of life caused, in part but not wholly, by its negative emotional impact.Some of the most prevalent mental symptoms presented by Long COVID patients are anxiety, depression and sleep disorders.Objectives: The objective of this study is to increase understanding of the affective state of people diagnosed with Long COVID, the evolution and associated factors.Methods: Longitudinal study of three months of duration.The study population was 100 post-COVID-19 patients aged 18 years or older (80 women and 20 men).The main variable was the affective state through the Hospital Anxiety and Depression Scale (HADS) questionnaire.The rest of the collected variables were: Sociodemographic variables, number of residual symptoms, cognitive functioning using the Montreal Cognitive Assessment (MoCA), physical functioning variable measured by Sit to Stand Test and Sleep quality through the Insomnia Severity Index (ISI).A statistical analysis comparing baseline and 3months follow up measures were performed, using a Student T for related samples statistical.A lineal regression analysing associated factors to a reduction in HADS score was also performed.Ethics approval was granted by the Clinical Research Ethics Committee of Aragón (PI21/139 and PI21/454).Results: At baseline the score in anxiety, depression and total score were 9,10 (SD: 4,67), 8,25 (SD: 4,51) and 17,35 (SD: 8,43) respectively, and 74% of the participants were considered cases.At three months, there is a slightly decrease but not significative in the score of HADS, both in anxiety, depression and total score (pvalue 0,465; 0,236; and 0,216 respectively).64,4% of the participants had a positive diagnosis of depression/anxiety.About the rest of the variables there were also a slight decrease but without being significant There was not a predictive model that explained the decrease in the HADS score.Conclusions: The evolution of the people suffering long covid is very slow along the time, and also the affective state.Previous studies on events that required isolation situations suggest a worsening in the mental health of general population, and in particular, of especially vulnerable groups such as individuals with severe mental disorder (SMD).Objectives: The aim of this study is to evaluate the psychological effect (anxiety and depression) of confinement in patients with SMD and to study the dissimilarities among the different diagnostic groups.Methods: In this study, assessments were performed using the IDER and STAI questionnaires, in order to evaluate symptoms of depression and anxiety, respectively.The evaluations were carried out in patients who had required at least one admission to the Psychiatric Hospitalization Unit of the University Hospital of Basurto.The Shapiro-Wilk test was used to verify the normality of the sample.ANOVA test was used to study differences among diagnostic groups.Posteriorly, Bonferroni correction was performed.Results: 95 participants completed the IDER questionnaire, obtaining a mean score of 24.56 (SD=8.18)for the state and 23.57(SD=8.14)for the trait.In the STAI questionnaire, a mean score of 27.86 (SD=15.19)was obtained for the state and 30.49(SD=14.71)for the trait.ANOVA test indicated presence of differences among groups.However, differences did not persist after Bonferroni correction.Conclusions: Increased levels of anxiety and depression were found in the sample studied with respect to the general population.No statistically significant differences were found among different disgnostic groups.Further studies should be performed in order to increase the knowledge around this research area.

EPV0296
A case report of post-acute COVID-19 encephalopathy Introduction: Following the protracted duration of the coronavirus pandemic, the Serbian health system now faces a period of mid-and long-term health consequences in patients that have recovered from the acute phases of infection.Objectives: A 57-year-old woman presented at a psychiatric examination complaining of forgetfulness, listlessness, fatigue, insomnia, low mood, and decreased efficacy in daily activities, two months after infection with the SARS-CoV-2 virus.The clinical picture of acute COVID-19 infection was accompanied by an elevated body temperature, a cough, an increases of CRP, and X-ray verified bilateral pneumonia with band-like speckled shadows of milk glass density.Before infection, she was vaccinated with 3 doses of the Sinopharm Covid-19 vaccine.Methods: The following examinations were made: MRI of endocranium, HDRS, laboratory examination, and neuropsychological testing.
Results: MRI of endocranium (figure 1): extensively corticosubcortical lesions extensively within both cerebral hemispheres, dominantly in the temporo-insular regions, in association with partial parenchymal defects and a high degree of atrophy -the overall morphology corresponds to chronic encephalopathy, which is of non-specific morphology; HDRS score of 24; elevated serum levels of IgM, IgG, albumin in serum 7. 05 (35-55), albumin in cerebrospinal fluid 812.0 (0-35), albumin index 115.8(<9.0);IEF: oligoclonal bands in CSF and serum; neuropsychological testing: decrease in general mental activity and visuoperceptive and visuospatial ability.Due to the temporal connection between infection with the SARS-CoV-2 virus and presented symptoms, the patient was diagnosed with post-acute COVID-19 encephalopathy.

Image:
Conclusions: A meticulous follow-up post-acute SARS-CoV-2 infection monitoring and care could decrease mortality and prevent debilitating neurological and other burdens, especially in risk groups.

EPV0297
Adjustment strategies adopted by higher education students during COVID-19 pandemic: focus group discussions C. Laranjeira1,2 *, M. Dixe 1,2 , Z. Charepe3 and A. Querido 1,2  Introduction: With the closure of higher education institutions during the COVID-19 sanitary crisis, students have experienced problems such as interruptions to their education, loss of peer support networks, and mental health issues.
Objectives: This study aimed to explore adjustment patterns used by students to overcome the impact of the COVID-19 pandemic.Methods: A qualitative descriptive study was developed by carrying out Focus Group Discussions (FGDs).Portuguese students enrolled in education levels above high school, including undergraduate and graduate programs, were considered eligible.Participants were recruited using convenience sampling.Each FGD took approximately 60-90 min.Results: Twelve students were participated in 2 FGDs, each one with 6 participants.Mostly were undergraduate students (Bachelor's degree), in the field of health area.The thematic analysis revealed three main themes.The first theme was related to the personal sphere and included most of adjustment strategies used, namely: pandemic as a "window of opportunity" to be involved in new academic and professional projects; work-life balance by organizing and separating work from private life; selfcare through the adoption of healthy lifestyles; being compassionate with others and compliance with sanitary measures.In the social sphere, students evoked new ways of communicating via digital networking to compensate for the lack of physical proximity and stay in safe contact with friends and relatives.In the contextual sphere, students talked about the importance of adapting the "teaching/learning" environment.Tailored teaching support was a significant strategy, especially in maintaining their motivation.Conclusions: Several strategies were pointed by students to stay mentally healthy and mitigate delayed-onset post-traumatic stress disorder during the COVID-19 pandemic.Besides, positive coping and hope should be integrated into the standard training of students across all study areas.

Disclosure of Interest: None Declared
Disclosure of Interest: None Declared EPV0295 PSYCHOLOGICAL IMPACT OF COVID-19 LOCKDOWN ON A POPULATION WITH SERIOUS MENTAL DISORDER: DIAGNOSTIC GROUP ANALYSIS B. Pedruzo*, C. Aymerich, A. Catalan, M. Pacho, M. Bordenave, O. Estevez, J. Herrero, M. Laborda, G. Mancebo, J. L. Perez and M. A. Gonzalez Torres Introduction: Since its emergence at the end of 2019, the COVID-19 virus has spread worldwide.In Spain, mandatory home confinement was established on March 15, 2020, and lasted 99 days.